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NURSING MATERNITY

Pregnancy Doubles (Gemelli) 

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Pregnancy double (Gomelli )

Pregnancy double or twin pregnancy is a pregnancy with two or 

more fetuses. (Obstetrics: 386)

If process of fertilization produces more than one fetuspregnancies were then is called to the double pregnancy.

Gemelli (2)

Triplet (3)

Kuadruplet (4)

Quintiplet (5)

Sextuplet (6)

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ETIOLOGY  Factors that affect:

Genetic or hereditary factors,age

parity, race / ethnicity drug triggers ovulation: Profertil, Clomid, andgonadotropin hormones can lead to pregnancy and

dizygotic twins more than two. Another unknown factor.

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Type of Pregnancy double (Gomelli )

MonozygoticTwin pregnancies that occur from one egg is called alsocalled monozygotic twins identical, homologous orunivoler. Monozygotic twins means the spermfertilized the egg, then splitting in two.

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Dizygotic

is also called heterologous, binovuler, or fraternal. Thesame or different sexes, they are as different as theother children in the family. Dizygotic twins have twoplacentas, 2 2 chorion and amnion. 2 Sometimes theplacenta becomes one.

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 Picture 3:Placenta and fetal membranes dizygotic twins. (A): 2 placenta, 2 chorion,

amnion 2. (B): 2 placenta (being one), 2 chorion, amnion 2.

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Picture 5: The placenta and umbilical cord twins

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superfecundation Superfecundation is the fertilization of two eggs

released at ovulation same on 2 coitus is done withshort intervals. Thus pregnancy is difficult todistinguish from dizygotic twins.

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 PRESENTATION ON FETAL POSITION

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A.Both child lies head.

B.The location of the head, the other where the buttocks.

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TWIN PREGNANCY DIAGNOSIS anamnesis

- Bloated Abdomen more than it should be inaccordance with his age pregnancy - Fetal movement felt more pregnant mothers- The uterus enlarges noticeably faster- History twin offspringelectrocardiogram total

There is a picture of two different ECG of bothfetus.

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auscultation2 audible fetal heart rate at 2 placesrather far apart at least the speed difference

10 beats per minute or when calculated togetherthere is a difference of 10.

 Abdominal x-ray photo

2 shows images of the fetus.

ultrasonography If it looks 2 fetal or two heart beats which has to be determined on a quarterly I.

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 EFFECT OF MOTHER AND FETUS

motheranemiahypertensionparturition Prematurusatonia uteriPostpartum hemorrhage

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baby hydramniosMalpresentasiplacenta previaabruptio placentaPremature rupture of membranes and toxemia gravidarumIntrauterine growthcongenital abnormalitiesIncreased perinatal morbidity and mortality 

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PROGNOSIS mother:

prolonged labor

Trauma to the birth canal Post partum bleeding

toxemia gravidarum, hydramnios, anemia,

High perinatal mortality rate is mainly due to

prematurity, abruptio placenta and obstetric measuresfor fetal abnormality lies

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Nursing Diagnosis 1. Inbalance nutrition: less than body requirements

related to the increased nutritional needs of the mother

and fetus.

2. Impaired sense of comfort (tightness) associated

 With lung expansion is not optimal.

3. Anxiety related to lack of knowledge of themanagement of twin pregnancy procedure .